YEKEEN ODEWALE NPI 1184175697

NPI Information

NPI: 1184175697
Provider Name: YEKEEN ODEWALE
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
5411 OLD FREDERICK RD STE 7
BALTIMORE, MD
ZIP 21229
Phone: (410) 762-8945
Get Directions

Yekeen Odewale is a psychiatric/mental health nurse practitioner in Baltimore, MD. Yekeen Odewale NPI is 1184175697. The provider is registered as an individual entity type and is a multiple single specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5411 OLD FREDERICK RD STE 7
BALTIMORE, MD
ZIP 21229
Phone: (410) 762-8945

The NPI 1184175697 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/19/2016 and was last updated on 7/20/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WP0809X	Registered Nurse	Psychiatric/Mental Health, Adult	R212715	MARYLAND	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	R212715	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	117396100	MEDICAID	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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